• Archives of Plastic Surgery
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• v.37 no.4
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• pp.461-464
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• 2010

Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.455-460
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• 2008

Purpose: We have classified blepharoptosis into the categories including pseudoptosis in Koreans and compared with other previous studies. Methods: Total of 250 patients(398 eyes) who underwent surgery for blepharoptosis from 1987 to 2006 were studied. By classification of Beard, patients were categorized into congenital, acquired and pseudo blepharoptosis and later they were reclassified by their etiologies. Also addition of pseudoptosis to the classification of Frueh, blepharoptosis were categorized into neurogenic type, myogenic type, aponeurotic type, mechanical type and pseudoptosis. And we divided these cases by the degree of blepharoptosis, levator function and the operation methods. Results: Out of the 250 patients, 175 patients were congenital type, 49 were acquired type and 26 were pseudoptosis. According to the mechanistic classification, 177 myogenic type, 30 aponeurotic, 7 mechanic, 8 neurogenic and 28 pseudoptosis were categorized. Regarding severity of blepharoptosis, there were 29.2% of mild, 40% of moderate, and 30.8% of severe cases. Out of the 398 cases, in terms of the operation methods, there were 39 aponeurosis plication, 184 levator resection, 5 Muller tucking, 60 Orbicularis oculi muscle flap, 66 frontalis transfer, and 21 blepharoplasty. Conclusion: The cause and degree of ptosis, and levator function are very important when considering the amount of resected muscle. There were only a few studies about blepharoptosis classification including pseudoptosis category. Therefore, through this study, we can investigate the relationship between the pseudoptosis and the others. This study could be useful for the making future management plans of blepharoptosis in Korean patients.

• Journal of Oriental Neuropsychiatry
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• v.20 no.4
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• pp.161-172
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• 2009

Objectives : This study was designed to research the effect of oriental treatments for Hwabyung with Blepharoptosis. Methods : A 51 year-old female patient has been suffered by Hwabyung for 5 months and by Blepharoptosis for 2 weeks. We treated the patient with Herbal medication, oriental psychotherapy and acupuncture. Results : As a result of oriental treatments, Blepharoptosis was disappeared, and the symptoms of Hwabyung was improved gradually. Conclusions : These result suggest that oriental treatments have an effect on Hwabyung with Blepharoptosis.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.743-749
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• 2009

Purpose: Many researches about various surgical method for blepharoptosis have already been introduced. But researches for complications after blepharoptosis correction is relatively insufficient. So, this study was performed to recognize common complications that arised depending on the severity of blepharoptosis, levator function and surgical method. Methods: 250 patients who have underwent surgical treatment for blepharoptosis from 1987 to 2006 were employed in this study. Patients were categorized by severity of blepharoptosis, levator function and surgical method that has been used. Complications after blepharoptosis correction were analyzed. Result: Total of 64 patients had occurred complications, the specifics are as following; undercorrection 22, asymmetry 13, overcorrection 12, lagophthalmos 4, abnormal eyelid contour 4, exposure keratitis 3, ectropion 2, inclusion cyst 2, infection 1 and conjunctival prolapse 1. Among above patients, 3 patients had two kinds of complications. 21 patients was underwent secondary surgery due to complication. Conclusion: Evaluating the outcomes of the secondary surgery, the early correction was better than the late correction. The most of the complications were recovered through conservative and surgical treatments. The most of the complications (47 patients) were undercorrection, asymmetry, overcorrection and took 73.4% of the total complications. The more severe the blepharoptosis and the more poor the levator function, the rate of complications were higher. According to the operation methods, most complications were occurred in levator operation, frontalis transfer and OOM flap.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.446-451
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• 2023

Background Elderly patients often have complications of blepharoptosis surgery that can result in the appearance or exacerbation of superficial punctate keratopathy (SPK). However, postoperative changes to SPK status have not been previously reported. We used subjective assessment of symptoms and measurement of SPK scale classification to investigate the safety and efficacy of blepharoptosis surgery in elderly patients. Methods Included in this prospective study were 22 patients (44 eyes) with bilateral blepharoptosis that underwent surgery. Patients comprised 8 males and 14 females with a mean (±standard deviation) age of 75.7 ± 8.2 years (range: 61-89). Blepharoptosis surgery consisted of transcutaneous levator advancement and blepharoplasty including resection of soft tissue (skin, subcutaneous tissue, and the orbicularis oculi muscle). Margin reflex distance-1 (MRD-1) measurement, a questionnaire survey of symptoms and SPK scale classification, was administered preoperatively and 3 months postoperatively for evaluation. Results The median MRD-1 was 1 mm preoperatively and 2.5 mm postoperatively, representing a significant postoperative improvement. SPK area and density scores were found to increase when the MRD-1 increase was more than 2.5 mm with surgery. All 10 items on the questionnaire tended have increased scores after surgery, and significant differences were observed in 7 items (poor visibility, ocular fatigue, heavy eyelid, foreign body sensation, difficulty in focusing, headaches, and stiff shoulders). Conclusion Blepharoptosis surgery was found to be a safe and effective way to maintain the increase in MRD-1 within 2.0 mm. Despite the benefits, surgeons must nonetheless be aware that blepharoptosis surgery is a delicate procedure in elderly people.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.2
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• pp.159-164
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• 2004

Blepharoptosis is the state that upper eyelid sagges, palpebal fissure becomes narrow due to disorder of a levator palpebrae superioris or innervation. It affects not only the physical vision but also mental shrink. In the view of oriental medicine, there are various causes, among them mainly cause is the deficiency of spleen Gi. The other hand, we treated a patient who suffered from blepharoptosis(with headache, exotropia, dizziness) differentiate from stagnation of Gi(energy) and blood stasis with Sungihwalhyeoltang(順氣活血湯) mostly. After about 40days of Sungihwalhyeoltang(順氣活血湯) centered treatment, acupunture, we observed an improvement Based on this experience, it is considered that stagnation of Gi(energy) and blood stasis can bring about blepharoptosis.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.201-208
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• 2018

Objectives: This is a case report about the effect of Korean medicine on blepharoptosis and ocular motility disorders that occur with thalamus, midbrain, and cerebellum infarctions. Methods: The patient was treated using Korean medicine such as acupuncture, moxibustion, and herbal medicine (Boyanghwano-tang-gamibang). The change of blepharoptosis was evaluated by measurement of palpebral fissure width (PFW), marginal reflex distance-1 (MRD1), and marginal reflex distance-2 (MRD2). The change inocular motility disorders was evaluated by comparison using photographs of the extraocular movements of the patient. We used the Numeric Rating Scale-11 (NRS-11) of diplopia and dizziness to evaluate the effectiveness of treatment. Results: After treatment, blepharoptosis and ocular motility disorders were improved. The NRS-11 score of dizziness decreased from 10 to 7, and diplopia disappeared after Korean medicine treatment. Conclusions: According to this study, Korean medicine can be effective for treating blepharoptosis and ocular motility disorders in thalamus, midbrain, and cerebellum infarctions.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.130-134
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• 2012

Purpose: Brown syndrome is motility disorder of the eyeball which shows limited elevation in adduction and occurs very rarely after eye surgery. The authors have experienced a case of strabismus-like Brown syndrome combined with blepharoptosis and report this case with the review of literatures. Methods: A 28-year-old female suffered from hypotropia in the primary gaze and severe blepharoptosis with diplopia of the right eye after upper blepharoplasty. Rotation showed an inability to elevate the adducted right eye. She underwent extraocular muscle surgery about the 7 mm tucking of the right superior rectus muscle and 6 mm recession of right inferior rectus muscle. Intraoperatively, injury of the superior rectus muscle and foreign body were observed. Seven months after the extraocular surgery, the patient underwent frontalis muscle transfer on the right upper eyelid for the correction of blepharoptosis. Results: Postoperatively, the patient was orthophoric in the primary gaze, and she had improvements in the correction of blepharoptosis and eyeball movement. Conclusion: Repeated eyelid surgeries increase the risk of ocular motility disorder. Careful approach is essential for the proper treatment and successful outcome in secondary surgeries.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.95-100
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• 2006

The challenge of accurately predicting eyelid height after blepharoptosis surgery is well-known problem even in complete hands. From May, 1988 to December, 2004, authors reviewed 182 cases(240 eyes) of blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 10 cases(15 eyelids) of early reoperation around 1 week. The period from initial operation to reoperation are between six to eight days and mean period is seven days. Initial operative procedures were frontalis muscle transfer in 3 cases(4 eyelids) and levator resection in 7 cases(11 eyelids). Follow up period ranged from 6 months to 16 years. Early adjusting surgery was performed in accordance with the preoperative and postoperative degree of ptosis of patient and considering previous operative technique. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan. Seven patients have good or satisfactory results(less than 1 mm asymmetry, good in 5 cases and satisfactory in 2 cases). Three patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry). Even if early or late reoperation can be effective in correcting unsatisfactory results after correction of blepharoptosis, early reoperation is better than later reoperation because early reoperation can offer a reduction in time to final result, the ease with which it is performed, potential cost savings. The experience of surgeon is also important factor for the reatment of recurred blepharoptosis

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.135-138
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• 2014

A 34-year-old female was suffered from pain and numbness of right arm for 2 months after undergoing a thoracoscopic procedure for a posterior mediastinal mass that was diagnosed as neurilemmoma. The patient was diagnosed as a complex regional pain syndrome type 2 with brachial plexopathy developed during thoracoscopic excision of posterior mediastinal mass, and stellate ganglion block (SGB) with 0.2% ropivacaine 10 mL was performed every 3-4 days. The patient revealed slightly prolonged blepharoptosis as Horner syndrome accompanied after every SGB and recovered. However, following the 23rd SGB, the blepharoptosis persisted and patient was recovered spontaneously from blepharoptosis after about 12 months. The possibility that the persistent blepharoptosis might be caused by brachial plexopathy related to patient's pathology or surgical manipulation and/or repeated SGB. If Horner syndrome occurs, its etiology should be assessed, and it would be necessary to explain and to assure the patient the possibility of recovery spontaneously from the complication within a year, without any sequelae.